Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care

Müller, Alex F.; Drexhage, Hemmo A.; Berghout, A

doi:10.1210/edrv.22.5.0441

Cited by 223 publications

(151 citation statements)

References 253 publications

(256 reference statements)

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“…Such exposure to allogeneic proteins may represent the link between autoimmunity and genetic polymorphisms, as described in post-transfusion purpura [13]. Other autoimmune diseases favoring this hypothesis and displaying a sex bias are postpartum thyroiditis [14], systemic lupus erythematosus [15] and peripartum cardiomyopathy [16]. Nevertheless, women without pregnancies, men, and children are also likely to be exposed to alloantigens, as maternal cells also traffic into the fetal circulation.…”

Section: Introductionmentioning

confidence: 99%

Single nucleotide polymorphisms as a prerequisite for autoantigens

et al. 2005

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It is still elusive why certain self proteins induce an autoimmune response. One immunological hypothesis is that only modified or altered self‐proteins may become a target. Thus, we asked whether such alterations may actually be genetic polymorphisms that can be revealed by analyzing sequence variability in the known human autoantigens. Indeed, we found autoantigens to contain significantly more single nucleotide polymorphisms (SNP) than other human genes do. Our finding may offer an explanation for autoimmune responses through allogeneic exposure. Besides other contributing factors in autoimmunity, SNP may represent an essential prerequisite for the primary induction of an autoimmune response.See accompanying Commentary: http://dx.doi.org/10.1002/eji.200425888

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Section: Introductionmentioning

confidence: 99%

Single nucleotide polymorphisms as a prerequisite for autoantigens

et al. 2005

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“…What proportion of maternal hypothyroxinemia during pregnancy can be attributed to elevated TPO autoantibodies (TPOaAbs), for instance, has not been established, nor whether elevated TPOaAbs necessarily reduce thyroxine availability to the developing fetal brain. Nonetheless, several studies of pregnant women with elevated TPOaAbs found that their children had impaired intellectual performance whether or not the mothers also had experienced clinical thyroid dysfunction (11)(12)(13). Investigators from one study reported that children of women with elevated TPOaAbs but normal thyroid function during late gestation scored 10.5 points lower on the McCarthy scale (a proxy for IQ) than those born to women who were TPOaAb-negative (13).…”

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confidence: 99%

Childhood IQ, hearing loss, and maternal thyroid autoimmunity in the Baltimore Collaborative Perinatal Project

et al. 2012

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Background: Maternal thyroid autoantibodies during pregnancy have been implicated in neurodevelopmental delays, including early childhood cognitive deficits. We evaluated whether maternal autoantibodies to thyroid peroxidase (TPOaabs) during late pregnancy were associated with childhood intelligence quotient (IQ) scores in their offspring and how the children's TPOaab-associated sensorineural hearing loss (hL) might affect the result. Methods: We evaluated banked third-trimester sera corresponding to 1,733 children for whom childhood cognitive test scores and audiology data were available. The mothers and their children participated in the National Institutes of health (NIh)-sponsored collaborative Perinatal Project (cPP) that ran from 1959 to 1974. results: a modest, statistically significant, effect of TPOaabs on cognitive performance observed at 4 y of age lessened in both magnitude and P value by the age of 7 y. children with sensorineural hL (sNhL) had lower IQ scores at both ages. conclusion: Our data suggest that the reported effect of maternal TPOaabs on IQ may involve early developmental delays or transient effects rather than permanent deficits. Reports associating TPOaabs directly with IQ may reflect a portion with unexamined TPOaab-associated sNhL. Whether the TPOaab-associated sNhL is in the neurodevelopmental pathway of later cognitive delays or is independently associated with IQ requires investigation in other studies.

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“…At present TPOAb is generally recommended as an useful prognostic factor for development of PPTD [5][6][7][8][9] and particularly fi rst-trimester TPOAb titers showing positive predictive value in assessing the risk of postpartum thyroid disorders. 10 In our study the presence of TPOAb in early pregnancy proved to be a signifi cant prognostic factor for the occurrence of PPTD.…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for Postpartum Thyroid Dysfunction in Euthyroid Women Prior to Pregnancy

et al. 2017

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Citation: Nonchev BI, Argatska AV, Pehlivanov BK, Orbetzova MM. Risk factors for postpartum thyroid dysfunction in euthyroid women prior to pregnancy. 2017;59(2):190-196. doi: 10.1515/folmed-2017-0027 Background: Thyroid dysfunction is common during the postpartum and the predisposing factors for its development are considered specifi c for the population studied. The aim of this study was to evaluate the risk factors for the occurrence of postpartum thyroid dysfunction (PPTD) in euthyroid women prior to pregnancy. Materials and methods: Forty-fi ve women with PPTD and 55 age-matched euthyroid postpartum women from Plovdiv, Bulgaria were included in the study. TSH, FT4, FT3, TPOAb, TgAb, TRAb were measured and ultrasound evaluation of the thyroid was performed in the fi rst trimester of pregnancy and during the postpartum. Results: The study found higher risk of developing PPTD in women with family history of thyroid disease (OR 4.42; 95% CI 1.87,10.43), smokers (OR 4.01; 95% CI 1.72,9.35), personal history of autoimmune thyroid disease (OR 5.37; 95% CI 1.15,28.53), positive TPOAb (OR 18.12; 95% CI 4.93,66.65) and thyroid US hypoechogenicity during early pregnancy (OR 6.39; 95% CI 2.53,16.12) and those who needed levothyroxine during pregnancy (OR 3.69; 95% CI 1.28,10.61). BMI before pregnancy was signifi cantly lower in women with PPTD than in euthyroid postpartum women (22.80±0.55 vs 26.25±0.97, p=0.013). The multivariate logistic regression analysis identifi ed as most important independent risk factors for PPTD occurrence the TPOAb positivity during early pregnancy, family history of thyroid disease, smoking and lower BMI before pregnancy. Conclusion: Our data suggest that in the population studied several factors are associated with an increased risk of PPTD and screening for thyroid disorders among those women can be benefi cial. Folia Medica BACKGROUND

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Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care

Cited by 223 publications

References 253 publications

Single nucleotide polymorphisms as a prerequisite for autoantigens

Single nucleotide polymorphisms as a prerequisite for autoantigens

Childhood IQ, hearing loss, and maternal thyroid autoimmunity in the Baltimore Collaborative Perinatal Project

Risk Factors for Postpartum Thyroid Dysfunction in Euthyroid Women Prior to Pregnancy

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